title: Anti-glomerular basement membrane disease treated with mycophenolate mofetil, corticosteroids, and plasmapheresis.
abstract: An 18-year-old woman presented with anemia, pulmonary hemorrhage, and necrotizing glomerulonephritis, and was diagnosed with anti-glomerular basement membrane (anti-GBM) disease. Treatment was undertaken with plasma exchange, mycophenolate mofetil and corticosteroids, due to patient refusal of cyclophosphamide. Clinical remission was successfully induced with this fertility-sparing regimen. A relapse due to therapy non-adherence was successfully treated with a second course of plasmapheresis, mycophenolate, and steroids. Thereafter, 6 months of directly observed therapy resulted in a favorable outcome with well-preserved pulmonary and renal function. This case suggests the possibility that mycophenolate may have a role in the treatment of anti-GBM disease.
authors.affiliation: West Penn Allegheny Health System, Pittsburgh, PA, USA.
authors.forename: Mari
authors.initials: M
authors.lastname: Mori
authors.forename: Uzoamaka
authors.initials: U
authors.lastname: Nwaogwugwu
authors.forename: Gwendolyn R
authors.initials: GR
authors.lastname: Akers
authors.forename: Rita L
authors.initials: RL
authors.lastname: McGill
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D019867:Anti-Glomerular Basement Membrane Disease / Q000628:therapy*; D005260:Female; D059247:Fertility Preservation; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D009173:Mycophenolic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D058958:Organs at Risk; D010956:Plasmapheresis
chemical_list: D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents; D009173:Mycophenolic Acid